# Medicare Coverage Change Impact Report (`taroyamada/medicare-coverage-change-impact-report`) Actor

Track public CMS national coverage reports and NCD/NCA records, then receive source-linked change alerts, descriptive impact reports, and JSON exports. Baselines and unchanged checks emit zero rows and zero charges. No license agreement token endpoint is used.

- **URL**: https://apify.com/taroyamada/medicare-coverage-change-impact-report.md
- **Developed by:** [naoki anzai](https://apify.com/taroyamada) (community)
- **Categories:** Business
- **Stats:** 2 total users, 1 monthly users, 100.0% runs succeeded, 0 bookmarks
- **User rating**: No ratings yet

## Pricing

from $5.00 / 1,000 cms coverage rows

This Actor is paid per event. You are not charged for the Apify platform usage, but only a fixed price for specific events.

Learn more: https://docs.apify.com/platform/actors/running/actors-in-store#pay-per-event

## What's an Apify Actor?

Actors are web data automations that power AI and operations. They run on the Apify platform to scrape websites, process data, connect APIs, and automate workflows.
In Batch mode, an Actor accepts a well-defined JSON input, performs an action which can take anything from a few seconds to a few hours,
and optionally produces a well-defined JSON output, datasets with results, or files in key-value store.
In Standby mode, an Actor provides a web server which can be used as a website, API, or an MCP server.
Actors are written with capital "A".

## How to integrate an Actor?

If asked about integration, you help developers integrate Actors into their projects.
You adapt to their stack and deliver integrations that are safe, well-documented, and production-ready.
The best way to integrate Actors is as follows.

- **AI agents and MCP clients** — the [Apify MCP server](https://docs.apify.com/integrations/mcp.md) at `https://mcp.apify.com` (remote, streamable HTTP, OAuth on first use).
- **Agentic workflows and local Actor development** — [Agent Skills](https://apify.com/.well-known/agent-skills/index.json) with the [Apify CLI](https://docs.apify.com/cli/docs.md): `npm install -g apify-cli`, then `apify login`.
- **JavaScript/TypeScript projects** — the official [JS/TS client](https://docs.apify.com/api/client/js/docs.md): `npm install apify-client`.
- **Python projects** — the official [Python client](https://docs.apify.com/api/client/python/docs.md): `pip install apify-client`.
- **Any other language** — the [REST API](https://docs.apify.com/api/v2.md).

For usage examples, see the [API](#api) section below.

For more details, see Apify documentation as [Markdown index](https://docs.apify.com/llms.txt) and [Markdown full-text](https://docs.apify.com/llms-full.txt).

# README

## Medicare Coverage Change Impact Report

Healthcare policy and coverage research teams enter public CMS national coverage watches; the input is a saved search by source, document, keyword, status, topic, or date.
The Actor reads only the official CMS Medicare Coverage API v1 public national endpoints and compares each response with an isolated recurring baseline.
The output is source-linked NCD/NCA change alerts, a descriptive coverage impact report, and an optional JSON export; baseline and unchanged checks emit zero rows and zero charges.

### Store Quickstart

```json
{
  "watches": [
    {
      "id": "national-updates",
      "sources": [
        "whats_new_national"
      ],
      "keywords": [
        "coverage"
      ],
      "effectiveDateFrom": "2026-01-01",
      "effectiveDateTo": "2026-12-31"
    }
  ],
  "monitorKey": "national-updates-2026",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}
```

1. Run the first watch with `initialRunMode: "baseline_only"` to establish a free snapshot.
2. Run the same `monitorKey` later with `generateReport: true` and `emitUnchanged: false`.
3. Use `initialRunMode: "emit_backfill"` only when you explicitly want the current matching public records and a paid report immediately.
4. Set `emitExport: true` when an external workflow needs the source-linked JSON export.

The Actor uses no API key and no CMS license agreement token. It never calls the license-agreement endpoint and never sends an Authorization header.

### Input Examples

#### 1. National updates watch

```json
{
  "watches": [{
    "id": "national-updates",
    "sources": ["whats_new_national"],
    "keywords": ["coverage"],
    "effectiveDateFrom": "2026-01-01",
    "effectiveDateTo": "2026-12-31"
  }],
  "monitorKey": "national-updates-2026",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}
```

#### 2. NCD and NCA watch

```json
{
  "watches": [{
    "id": "ncd-nca-policy",
    "sources": ["ncd", "nca_cal"],
    "keywords": ["diagnostic"],
    "statuses": ["Published"]
  }],
  "monitorKey": "ncd-nca-policy",
  "initialRunMode": "emit_backfill",
  "generateReport": true,
  "emitExport": true,
  "emitUnchanged": false,
  "maxChargeUsd": 25
}
```

#### 3. Public NCD/NCA data watch

```json
{
  "watches": [{
    "id": "specific-public-documents",
    "sources": ["annual", "nca_cal"],
    "documentIds": ["NCD-EXAMPLE-2026"],
    "topics": ["technology"]
  }],
  "monitorKey": "specific-public-documents",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitExport": true,
  "maxRecordsPerWatch": 100,
  "maxChargeUsd": 25
}
```

### Output

The primary value rows are:

- `cms-coverage-change-alert`: one source-linked alert for a newly observed or changed public CMS coverage record.
- `cms-coverage-impact-report`: a descriptive report grouped by source, NCD/NCA type, status, topic, and effective date.
- `cms-coverage-export`: a compact JSON-ready export of normalized public records.
- `cms-coverage-row`: optional low-priced normalized public record rows when `emitRawRows` is true.

Normalized records contain public fields such as `documentId`, `documentType`, `title`, `status`, `effectiveDate`, `publicationDate`, `lastUpdatedDate`, `topic`, `description`, and `sourceUrl`. No contact fields, API keys, Authorization values, or license tokens are emitted.

See [`docs/sample-output.json`](docs/sample-output.json) for a representative alert, report, export, and row payload. It is illustrative and is not a live CMS result.

### Pricing

| Event | Price | When it is emitted |
| --- | ---: | --- |
| `cms-coverage-row` | `$0.005` | Optional normalized public row for a new or changed record |
| `cms-coverage-change-alert` | `$0.20` | New or changed public coverage record is detected |
| `cms-coverage-impact-report` | `$10.00` | An explicit change set is summarized |
| `cms-coverage-export` | `$6.00` | An explicit change set is exported |

There is no start charge. A first `baseline_only` run saves state and emits `0 rows / 0 charge`. A later unchanged run also emits `0 rows / 0 charge`, regardless of `emitUnchanged`. `maxChargeUsd` is checked before any row is pushed; a state-save failure fails closed and does not report a successful run.

### Compliance Guardrails

- Official CMS Medicare Coverage API v1 public national list-report endpoints only: What's New National, National Coverage NCD, National Coverage NCA/CAL, and National Coverage Annual.
- The Actor does not call `/v1/metadata/license-agreement/` or any endpoint marked as requiring a license agreement token.
- No login, browser session, Authorization header, private document, patient data, or non-public comment is used.
- The Actor does not provide medical advice, insurance advice, reimbursement advice, legal advice, coding advice, or coverage guarantees.
- It does not claim CMS endorsement, approval, certification, affiliation, or payment likelihood.
- Verify the current CMS source record and applicable local policy before making a healthcare, policy, operational, or commercial decision.

See [`docs/source-compliance.md`](docs/source-compliance.md) for the endpoint allowlist and prohibited uses.

### Run the next report

- [CMS Provider Ownership & Quality Change Report](https://apify.com/taroyamada/cms-provider-ownership-quality-change-report) for source-linked provider ownership and quality changes.
- [DailyMed Label Change Watch Report](https://apify.com/taroyamada/dailymed-label-change-watch-report) for public drug-label metadata and version changes.
- [FDA 510(k) Device Clearance Landscape Report](https://apify.com/taroyamada/fda-510k-device-clearance-landscape-report) for public device clearance record changes.

### Source

- [CMS Coverage API documentation](https://api.coverage.cms.gov/docs/swagger/index.html)
- [CMS Coverage API FAQ](https://api.coverage.cms.gov/)
- [CMS Medicare Coverage Center](https://www.cms.gov/medicare/coverage/center)

# Actor input Schema

## `watches` (type: `array`):

Bounded saved searches across public national CMS coverage sources. No local coverage article or LCD endpoints are included.

## `monitorKey` (type: `string`):

Stable isolated state namespace for a recurring public CMS coverage watch.

## `initialRunMode` (type: `string`):

baseline\_only stores the first observation with zero rows; emit\_backfill emits current matches for an explicit first report.

## `generateReport` (type: `boolean`):

Generate one descriptive report when new or changed public coverage observations are emitted.

## `emitRawRows` (type: `boolean`):

Emit optional low-priced normalized public coverage rows for each new or changed observation.

## `emitExport` (type: `boolean`):

Generate a compact JSON export when new or changed observations are emitted.

## `emitUnchanged` (type: `boolean`):

Accepted for compatibility, but unchanged observations always remain zero rows and zero charge.

## `maxRecordsPerWatch` (type: `integer`):

Maximum public records retained per watch/source after filtering.

## `maxChargeUsd` (type: `number`):

Fail closed before pushing any row if planned PPE charges exceed this cap.

## `dryRun` (type: `boolean`):

Return representative rows for all four configured event types without calling CMS, saving state, or charging PPE events.

## Actor input object example

```json
{
  "watches": [
    {
      "id": "national-coverage-updates",
      "sources": [
        "whats_new_national",
        "ncd",
        "nca_cal"
      ],
      "keywords": [
        "coverage"
      ],
      "effectiveDateFrom": "2026-01-01",
      "effectiveDateTo": "2026-12-31"
    }
  ],
  "monitorKey": "medicare-national-coverage-watch",
  "initialRunMode": "baseline_only",
  "generateReport": true,
  "emitRawRows": false,
  "emitExport": false,
  "emitUnchanged": false,
  "maxRecordsPerWatch": 100,
  "maxChargeUsd": 25,
  "dryRun": false
}
```

# API

You can run this Actor programmatically using our API. Below are code examples in JavaScript, Python, and CLI, as well as the OpenAPI specification and MCP server setup.

## JavaScript example

```javascript
import { ApifyClient } from 'apify-client';

// Initialize the ApifyClient with your Apify API token
// Replace the '<YOUR_API_TOKEN>' with your token
const client = new ApifyClient({
    token: '<YOUR_API_TOKEN>',
});

// Prepare Actor input
const input = {
    "watches": [
        {
            "id": "national-coverage-updates",
            "sources": [
                "whats_new_national",
                "ncd",
                "nca_cal"
            ],
            "keywords": [
                "coverage"
            ],
            "effectiveDateFrom": "2026-01-01",
            "effectiveDateTo": "2026-12-31"
        }
    ]
};

// Run the Actor and wait for it to finish
const run = await client.actor("taroyamada/medicare-coverage-change-impact-report").call(input);

// Fetch and print Actor results from the run's dataset (if any)
console.log('Results from dataset');
console.log(`💾 Check your data here: https://console.apify.com/storage/datasets/${run.defaultDatasetId}`);
const { items } = await client.dataset(run.defaultDatasetId).listItems();
items.forEach((item) => {
    console.dir(item);
});

// 📚 Want to learn more 📖? Go to → https://docs.apify.com/api/client/js/docs

```

## Python example

```python
from apify_client import ApifyClient

# Initialize the ApifyClient with your Apify API token
# Replace '<YOUR_API_TOKEN>' with your token.
client = ApifyClient("<YOUR_API_TOKEN>")

# Prepare the Actor input
run_input = { "watches": [{
            "id": "national-coverage-updates",
            "sources": [
                "whats_new_national",
                "ncd",
                "nca_cal",
            ],
            "keywords": ["coverage"],
            "effectiveDateFrom": "2026-01-01",
            "effectiveDateTo": "2026-12-31",
        }] }

# Run the Actor and wait for it to finish
run = client.actor("taroyamada/medicare-coverage-change-impact-report").call(run_input=run_input)

# Fetch and print Actor results from the run's dataset (if there are any)
print(f"💾 Check your data here: https://console.apify.com/storage/datasets/{run.default_dataset_id}")
for item in client.dataset(run.default_dataset_id).iterate_items():
    print(item)

# 📚 Want to learn more 📖? Go to → https://docs.apify.com/api/client/python/docs/quick-start

```

## CLI example

```bash
echo '{
  "watches": [
    {
      "id": "national-coverage-updates",
      "sources": [
        "whats_new_national",
        "ncd",
        "nca_cal"
      ],
      "keywords": [
        "coverage"
      ],
      "effectiveDateFrom": "2026-01-01",
      "effectiveDateTo": "2026-12-31"
    }
  ]
}' |
apify call taroyamada/medicare-coverage-change-impact-report --silent --output-dataset

```

## MCP server setup

```json
{
    "mcpServers": {
        "apify": {
            "type": "http",
            "url": "https://mcp.apify.com/?tools=fetch-actor-details,taroyamada/medicare-coverage-change-impact-report"
        }
    }
}

```

The hosted server signs you in with OAuth on first connect, so no API token belongs in this config. Clients without OAuth support can send an `Authorization: Bearer <APIFY_API_TOKEN>` header instead, using a token from API & Integrations in Apify Console (https://console.apify.com/settings/integrations).

## OpenAPI specification

Download the OpenAPI definition: https://api.apify.com/v2/actors/07Cj2gF58Baw5LzHN/builds/h603sKRoGDN9a40lQ/openapi.json